Provider Demographics
NPI:1386956894
Name:PAPAGEORGE, GEORGE PETER (MA, MFT)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:PETER
Last Name:PAPAGEORGE
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5776 STONERIDGE MALL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2832
Mailing Address - Country:US
Mailing Address - Phone:925-734-8772
Mailing Address - Fax:925-467-1497
Practice Address - Street 1:5776 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2832
Practice Address - Country:US
Practice Address - Phone:925-734-8772
Practice Address - Fax:925-467-1497
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31380106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist